Post traumatic stress disorder (PTSD) & our Veterans

This Veteran’s Day we solute the many soldiers who fight for our country and those who have lost their lives in doing so. It is a brave and courageous offering these men and women do for all of us with little return.

While we hear of war on television, death tolls and secret operations or captures we often never hear about those who suffer from post traumatic stress disorder or PTSD.

Reza Ghorbani, MD, ABIPP, FIPP has written this piece for my blog titled: “A Veteran’s Day Prescription: Let’s fight to end the pain Afflicting American Heroes.”

Not all wounds are sustained on the battlefield. For many soldiers, the effects of war continue to reverberate long after the fading echoes of gunfire. Veterans Day is a time to honor and respect the sacrifices of our men and women in uniform, and also shed light on the challenges these individuals face once back on U.S. soil. With over 21 million U.S. citizens classified as veterans and, unlike the U.S. population in general, the average age of our veterans decreasing due in large part to the lengthy wars in Iraq and Afghanistan, it’s a large audience to address. One lesser discussed challenge that increasingly affects our military past and present is emotional and physical pain.

Patients suffering from anxiety and stress are in a higher state of awareness and, as a result, are likely to a feel pain more intensely. The heightened pain response, then, may trigger emotional issues that over time create a cycle of pain in the brain. Once the loop is established, it’s difficult to disrupt.

The nexus between physical and emotional physical pain becomes a syndrome linked to lower immunity. One consequence is a condition called postherpetic neuralgia, which can follow a shingles outbreak. Once the painful rash and blisters have disappeared, the patient may continue to experience severe nerve pain in the form of a burning sensation.

Studies also show that vets undergo a series of nervous system changes leading to irritability, memory loss and, again, a disproportionate response to pain, including a sensation called phantom pain, which causes hurt even in a missing limb.

Sometimes doctors who try to manage pain may inadvertently make matters worse. A recent study in the Journal of the American Medical Association focused on treating mental disorders like PTSD with prescription painkillers in U.S. veterans of Iraq and Afghanistan. The research was done by the VA and concluded that while pain medications play some role in treating PTSD there are growing concerns that overuse and abuse of these opioids could lead to abuse and addiction.

Still, there are safer approaches that can mitigate their suffering. Identifying and practicing these safer approaches is critical to the long-term impact veterans will have on our healthcare system due to the continual lowering of their average age.

The first is early intervention. When pain lingers beyond expected healing, it’s a warning of underlying problems that may require medical treatment. Second, while lifestyle changes may be difficult for soldiers trying to adjust to civilian life, proper diet, exercise and avoidance of extremes are effective pain preventers. Third, there are safe and effective natural painkillers that can be used as an alternative to addictive prescription drugs. For complex cases, there are pain management specialists that can work out a plan for physical and emotional rehabilitation.

(About Ghorbani: Dr. Reza Ghorbani, author of newly released Secrets to a Pain Free Life and Harvard-trained, board-certified interventional pain management specialist, is president and medical director of the Advanced Pain Medicine Institute in Washington, D.C. Dr. Ghorbani is a diplomat of the American Board of Interventional Pain Physicians and the American Board of Anesthesiology, and a Fellow of Interventional Pain Practice. With decades of experience in interventional pain management, he is a recognized leader in the advanced treatment of acute and chronic pain. Dr. Ghorbani has devoted his entire career to helping patients overcome pain to enable a better quality of life.)